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8 Ways to Fight the Fear of Severe Allergies

“Fear, anger, and helplessness.” Those are some of the words Donna DeCosta, MD, uses to describe what it feels like to be the parent of children with severe allergies. Writing on her blog, Dr. DeCosta recalls thinking, “Why him? What next? Am I to blame? How am I to keep him safe?” She’s not alone. Nearly 6 million children in the United States have food allergies, and allergic reactions land a child in the emergency room every three minutes.

Protecting your children can be “overwhelming,” said DeCosta, especially when they’re not directly under a parent’s supervision. “Most parents feel like they can keep their kids safe at home,” said John Lehr, CEO of Food Allergy Research & Education. “It’s when they go out the door that they worry.”

“One thing that is difficult for parents is that there’s no test to tell how severe a reaction will be,” said Hugh Sampson, MD, professor of pediatrics and allergy and immunology at Mount Sinai Hospital. “A child could have only mild reactions and then suddenly have an episode of anaphylaxis.”

A potentially life-threatening allergic reaction, anaphylaxis causes a drop in blood pressure and difficulty breathing. It’s commonly triggered by food, as well as by insect bites or skin contact with rubber latex in some toys, pacifiers, and gloves.

DeCosta, a radiologist in Maryland, has two sons both of whom have food allergies. Her older son was a little over a year old when he had his first reaction to a peanut butter sandwich. He later tested positive for a tree nut allergy as well. Her younger son developed a rash when he was six months old and tested positive for an egg allergy.

“There are actions parents can take to effectively manage food allergies and reduce the risk of reaction,” DeCosta said. Here are some tips:

Educate your child. Make sure your child knows the basics of how to protect themselves, as well as how to recognize an allergic reaction and what to do if they have one. “They should know simple things like not sharing food, knowing to say ‘no thank you’ when someone offers them food, washing their hands, and how to tell a grown-up if they feel like they’re having a reaction,” said Lynda Mitchell, founder and senior director of Kids With Food Allergies. DeCosta warns that “eating a friend’s food, even if they have the same allergy, can be dangerous as the friend may not be as sensitive to the allergen.”

Talk to your child’s caregivers. If your child is under someone else’s supervision – whether it’s a grandparent, a coach, or a babysitter – make sure they’re informed. For kids with food allergies, DeCosta suggests you “make playdates safer for your child and less stressful for all involved by sending safe snacks for your child to eat.” If you’re concerned that a relative doesn’t understand the seriousness of food allergies, DeCosta said “consider bringing them to an allergy appointment or sharing allergy resources.”

Have an emergency plan. The Food Allergy Research & Education advocacy group has a care plan sheet that parents can print and fill out. It includes signs of a severe allergic reaction, how to administer epinephrine, and emergency contact information.

Communicate with your child’s school. DeCosta recommends sitting down with teachers at the start of the school year to discuss your child’s allergies. Parents should “provide necessary medications and any medical documentation required by their child’s school,” she said.

Read labels. “Make no assumptions regarding food ingredients,” DeCosta said. “Always read labels because precautionary statements and ingredients may change.” The Food Allergen Labeling and Consumer Protection Act of 2004 requires that all foods containing a “major food allergen” or a protein derived from one of the allergens must be labeled. Major allergens include milk, eggs, fish, shellfish, tree nuts, wheat, peanuts, and soybeans.

Ask questions. “When eating out at a restaurant, speak with the chef or manager about food preparation and safe food options,” said DeCosta. “Be cautious when eating at ice cream stores since the same scooper is often used in multiple containers and blenders may contain traces of allergens.”

Cover up. When outdoors, keep exposed skin to a minimum by putting kids in long-sleeved shirts and long pants.

Spray wisely. Insect repellents help keep bugs away, but “be careful when you use [ones containing the chemical] DEET on children,” said Susan Rehm, MD, vice chair of infectious diseases at the Cleveland Clinic. The U.S. Food and Drug Administration advises against using DEET on kids under 2 months of age. Regardless of age, children “should not be allowed to apply it themselves,” said Dr. Rehm.

As DeCosta points out, “proactively managing [your] child’s allergy and teaching him or her to do the same will help tremendously in reducing the stress associated with navigating school and social situations.”

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